When to Consider Surgery for Crohn’s Disease
Crohn's DiseaseTaking Control of Crohn’s

When to Consider Surgery for Crohn’s Disease

When to Consider Surgery for Crohn’s Disease
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Updated on February 19, 2026
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Surgery used to be considered a last-resort treatment option for people with Crohn’s disease, when nothing else was working. That advice is changing.

“Doctors who sent people with Crohn’s for surgery felt like they’d failed, but that’s no longer true,” says Raymond K. Cross, MD, a professor of medicine and the director of the Inflammatory Bowel Disease Program at the University of Maryland School of Medicine in Baltimore.

Surgery can’t cure Crohn’s, but can ease symptoms and provide long-term relief.

“Today, surgery is an option for Crohn’s that should be explored, particularly when complications are present,” Dr. Cross says. “Anytime I see a person with Crohn’s disease, I bring it up.”

When Is Surgery Recommended for Crohn’s?

Although newer medications have helped people control their symptoms (sometimes reducing the need for surgery altogether), surgical procedures are still very common, says Miguel Regueiro, MD, chair of the Digestive Disease Institute at Cleveland Clinic in Cleveland, Ohio.

Doctors are most likely to recommend surgery for Crohn’s if your medications don’t work, your drug treatment stops working, or you develop any of these complications:

  • A perforation or hole in your bowel
  • A blockage or stricture (narrowing of the intestine)
  • A fistula (an abnormal passageway)
  • An abscess

Some of these complications may require emergency surgery. Colon surgery may also be recommended to reduce the risk for cancer, which is increased by the chronic inflammation caused by Crohn’s, Dr. Regueiro says.

Common Surgeries for Crohn’s

Crohn’s can affect any part of the gastrointestinal tract, but the small intestine and colon are most typically affected.

 Different surgical procedures for Crohn’s exist, depending on the complication you’re having, where it's located, and the severity of your disease.

Surgical options for Crohn’s include the following.

Strictureplasty

Over time, chronic inflammation from Crohn’s can scar your intestines, causing a stricture.

If this narrowing of the intestine occurs in one of the lower sections of your small intestine (the jejunum or ileum), your doctor may recommend a strictureplasty, which involves cutting open the narrowed segment of bowel and stitching the tissue crosswise to widen it.

None of the intestine is removed, which potentially lowers the risk for short bowel syndrome, Regueiro says.

Fistulotomy

Some people with Crohn’s may develop a fistula, which occurs when an ulcer (or sore) caused by inflammation penetrates the wall of the gastrointestinal tract and forms a channel or loop in a nearby organ, such as the bladder, skin, or vagina.

Not all fistulas will need to be treated. But if they do, and antibiotics or other Crohn’s medications don’t resolve the problem, you may need this surgery to drain the infection and stop it from spreading.

Small- or Large-Bowel Resection

In a small- or large-bowel resection, the diseased section of the bowel is cut out and the healthy ends are reattached. If the procedure takes place in the small intestine, it’s known as a small-bowel resection. Large-bowel resections take place in the large intestine.

This procedure, which is used to treat strictures and bowel perforations, is the most common surgery for Crohn’s disease, Regueiro says.

Colectomy and Proctocolectomy

Your doctor may recommend a colectomy if your entire colon is affected by Crohn’s.

 You may need a proctocolectomy if your rectum is also affected.

During a colectomy, the surgeon removes the entire colon.

 In a proctocolectomy, the rectum is also removed. A proctocolectomy for Crohn’s usually requires an ileostomy, which creates an opening for stool to pass out of the body and requires wearing an ostomy bag to collect it.

Concern over having to live with an ostomy bag is normal, but after you adjust to it, you can resume your normal activities, and other people won’t know unless you choose to tell them.

Minimally Invasive Surgery for Crohn’s

Today, surgeons often perform surgical procedures for Crohn’s using a minimally invasive technique called laparoscopic surgery, which reduces postoperative pain, decreases the risk for complications like infection, and allows for a faster recovery.

“In the old days, people who underwent surgery for Crohn’s had a scar from their sternum to their pelvis,” Cross says. With minimally invasive techniques, the incisions are much smaller and the cosmetic result is much better.

The Risks of Surgery for Crohn’s

Surgery for Crohn’s is generally safe and effective, and the results are usually good. It can dramatically reduce symptoms that may have been limiting your life. “Almost everyone gets better with surgery,” Cross says.

Still, every surgery has its risks, including those associated with anesthesia as well as possible bleeding and infection. For example, adhesions, or bands of scarlike tissue, are a common side effect of abdominal surgery. These bands form inside of your abdomen.

A resection of more than half of the small intestine may lead to short bowel syndrome, which prevents the absorption of water, vitamins, and other nutrients from the food you eat, Regueiro says. This can cause you to become dangerously dehydrated and lose significant weight.

Short bowel syndrome can be treated with nutritional support and medications, but it may require intravenous nutrition (total parenteral nutrition) or, in extreme cases, an intestinal transplant, Cross says.

People who undergo a bowel resection often need more surgeries down the road.

“Within five years, 50 percent of people who undergo a bowel resection will come back, because they’re having recurring symptoms,” Regueiro says.

The inflammation commonly reappears adjacent to where the surgery was performed.

“Why this happens is the mystery of why Crohn’s happens at all,” he notes. Some people may need two or more additional surgeries. But this shouldn’t stop you from having surgery if you need it, Regueiro says.

If you have advanced or deep-seated Crohn’s, Regueiro recommends seeing a surgeon about a bowel resection. You can also work with your doctor to develop a postoperative treatment plan.

“The goal of surgery is to help keep you from getting sick again,” Regueiro says.

Is Surgery for Crohn’s Right for Me?

If surgery has been recommended to you, ask your doctor to go over the risks and benefits in detail.

If you decide to have surgery, do your best to care for yourself physically and mentally before your procedure, and build a support team that will help you prepare meals and manage other responsibilities while you’re recovering.

The Takeaway

  • While surgery used to be considered a last resort for treating Crohn’s disease, it’s become more common and less stigmatized.
  • Surgery can’t cure Crohn’s, but it can help with long-term management.
  • There are various types of surgery available that your doctor may recommend depending on where the complication is occurring, among other things.
  • Talk with your doctor about the risks and benefits before making a decision about surgery for Crohn’s disease.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Treatment for Crohn’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases. July 2024.
  2. Definition and Facts for Crohn’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases. July 2024.
  3. Strictureplasty. Cleveland Clinic. April 17, 2024.
  4. Fistulizing Crohn's Disease. Crohn's & Colitis Foundation.
  5. Total Abdominal Colectomy. MedlinePlus. September 30, 2024.
  6. Proctocolectomy and Colectomy. Crohn's & Colitis Foundation.
  7. Luglio G et al. Crohn’s Disease: Is Minimally Invasive Surgery the Gold Standard? A Narrative Review. Annals of Laparoscopic and Endoscopic Surgery. July 30, 2023.
  8. Abdominal Adhesions. National Institute of Diabetes and Digestive and Kidney Diseases. June 2019.
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Ira Daniel Breite, MD

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Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patients and helps run an ambulatory surgery center.

Dr. Breite divides his time between technical procedures, reading about new topics, and helping patients with some of their most intimate problems. He finds the deepest fulfillment in the long-term relationships he develops and is thrilled when a patient with irritable bowel syndrome or inflammatory bowel disease improves on the regimen he worked with them to create.

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